Healthcare Provider Details

I. General information

NPI: 1023923620
Provider Name (Legal Business Name): COMMUNITY PASTORAL COUNSELING SERVICE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30 N CLINTON ST
IOWA CITY IA
52245-1700
US

IV. Provider business mailing address

30 N CLINTON ST
IOWA CITY IA
52245-1700
US

V. Phone/Fax

Practice location:
  • Phone: 319-337-2519
  • Fax:
Mailing address:
  • Phone: 319-337-2519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State

VIII. Authorized Official

Name: JAMES LYNN JETTER
Title or Position: TREASURER
Credential:
Phone: 319-330-2803